Malta’s Place in the EU and in Healthcare

2017 began with Malta taking the Presidency of the EU Council with healthcare as a core theme in its programme. It is the first time that the tiny Mediterranean island with just over 400,000 people has held the reins of the European Union (EU), having been a member since 2004 and now assuming the Presidency for a period of 6 months. It is seeking to promote structured cooperation between health systems to improve access to innovative technologies and to address workforce challenges, including setting an agenda for more coordinated healthcare procurement.

The country can claim its own successes in healthcare. Malta has a rich history in medicine originating almost a thousand years ago with its first hospital founded by the Knights Hospitaller. More recently, in 2015 it was ranked 2nd in Europe for healthcare according to a study published by Business Insider which looked at criteria including service efficiency, staff competence, costs and equipment. Malta has been successful at establishing a cluster of manufacturing sites for pharmaceutical production, with other important sectors such as tourism and financial services. Life sciences are one of the key industries pursued by Malta’s development agency, Malta Enterprise, which has helped to establish an incubator space. The healthcare industry has helped Malta to restructure its economy since it voted for independence over 50 years.
Malta’s small size means at first glance it may be an unlikely candidate for a pharmaceutical cluster. However, several important factors have come together to make the unlikely come to life. The primary drivers of success are that so few pharmaceutical patents had been registered in Malta prior to its ascension to the EU, combined with the fact that retrospective patent filing is not possible under Maltese law. Unusually within the EU, Malta’s recognition of the Roche-Bolar Provision in 2003 in its most extensive sense means that it is possible for generic drugs to be developed while still under patent, and then released to the market upon patent expiry.

The country’s membership of the EU has augmented the power of its medical regulatory agencies, as their approvals can be used across the EU. The geographical position makes it ideal for exports to the Middle East and Africa. Malta’s tax system and investment incentives provided by the government add to the attraction to base operations there. The fact that English is an official language of the islands alongside Maltese means that there is a workforce ready to compete in the global pharma industry. In addition, this language proficiency has attracted Barts and The London School of Medicine and Dentistry to open a school in Malta, so bolstering the islands’ contribution to healthcare.

There are now over 30 pharmaceutical companies based on the island with exports of approx. €300m, employing over 2000 people or 1.2% of workforce. In comparison to other nations with much bigger pharmaceutical concerns, these numbers are easily dwarfed; however, they are significant given the size of the country. Nonetheless, they do make the industry highly impacted by closures of significant enterprises. Teva has recently announced­­ its plans to consolidate its European operations, which will lead to the closure of a plant and loss of more than 200 jobs in Malta by the end of 2017.

Overall, the EU Presidency needs to be seen in the context of the relatively short period of 6 months and the topics are likely to need to be debated and agreed beyond this time span. In terms of its healthcare industry, Malta hosts a significant cluster of enterprises for its size, based on the advantages it offers for generic manufacturing. Malta is also trying to target innovative medicine, which could help the industry to weather future changes in generics production.

To discuss this topic further and discover how Results Healthcare can work with you, please contact Daniel Mekic.